42D2183881 CLIA NUMBER - HEALTHSTAT ONSITE CLINIC - HARSCO RAIL

Laboratory Demographics

CLIA Number: 42D2183881

Facility Name: HEALTHSTAT ONSITE CLINIC - HARSCO RAIL

Facility Address:
2401 EDMUND ROAD
WEST COLUMBIA, SC
ZIP 29170
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Facility Phone Number: 704 936-5546

Facility Type: Other - CHRONIC MGT CLINIC

Certificate Type: Waiver

NPI Number: 1285263822

Taxonomy: 2083P0500X - Preventive Medicine
A preventive medicine physician who specializes in preventive medicine/occupational-environmental medicine, which is focused on protecting the population from occupational and environmental conditions.

CLIA Record

Field Name	Field Value
CLIA Number	42D2183881
LAB Type	Other - CHRONIC MGT CLINIC
Facility Name	HEALTHSTAT ONSITE CLINIC - HARSCO RAIL
Street	2401 EDMUND ROAD
City	WEST COLUMBIA
State	SC
ZIP	29170
Phone	704 936-5546
CertificateType	4
CertificateEffectiveDate	5/12/2022
CertificateExpirationDate	5/11/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024